Beneficiary Designation : of Life Insurance Policy or Pension Plan (IRA, or other Retirement plans):

You can furnish the following (or other appropriate language) to your insurance company or your retirement plan administrator. Ask them to provide you with the form needed.

“I hereby designate Integral Yoga Institute Inc., 227 West 13th Street, New York, NY, 10011 as recipient of $ __________ (or _________ %) of the proceeds of my [insurance policy or retirement plan].

Integral Yoga Institute Inc. EIN #13-6213660


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